Medical Fax Cover Sheet
Medical Fax Cover Sheet
FAX |
Date: August 19, 2051
To:
Dr. Evelyn Grant
Chief Medical Officer
New Horizon Medical Center
Fax Number: (555) 987-6543
From:
[YOUR NAME]
Medical Records Coordinator
[YOUR COMPANY NAME]
Fax Number: 222 777 0000
Contact Number: [YOUR COMPANY NUMBER]
Subject: Transfer of Patient Medical Records
Number of Pages (Including Cover): 7
Confidentiality Notice:
The information contained in this fax transmission is confidential and intended solely for the use of the individual or entity named above. If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution, or taking any action in reliance on the contents of this fax is strictly prohibited. If you have received this fax in error, please notify us immediately by telephone and destroy the original message.
Message
Dear Dr. Grant,
Please find enclosed the medical records for Mr. Robert Adams, as requested for the purpose of transferring care to your facility. These records include patient history, treatment notes, and recent lab results. Kindly confirm receipt of these documents at your earliest convenience.
If you require any further information or assistance, please do not hesitate to contact me directly.
Thank you for your prompt attention to this matter.
Sincerely,
[YOUR NAME]
Medical Records Coordinator
[YOUR COMPANY NAME]